Malcolm Lowry: Varicose veins and a mental block

Dr Chen’s article on varicose veins in the October issue of the BCMJ brought Malcolm Lowry to my mind. Mr Lowry is the famous author of Under the Volcano – a book that, according the New York Times, ought to be read by everyone interested in a passionate approach to the human experience. Mr Lowry is one of the 150 noteworthy British Columbians profiled in the Vancouver Sun newspaper’s “marking Canada’s 150th birthday” series.

The medical connection to Mr Lowry is that Dr Grenfell Clarence McNeill (1913-2002), my mentor and senior partner when I was practising family medicine, was Mr Lowry’s physician. Dr McNeill just started in private practice in the late 1940s and had opened a branch office in Deep Cove (North Vancouver) where there had been no physicians at that time. Mr Lowry and his wife lived in the Deep Cove area, in a tax-free house built on pilings below the high-tide mark.

At his first visit to Dr McNeill, Mr Lowry complained that he had pain in his legs that interfered with his work. It turned out that he had a mental block against holding a pen or pencil – and as he was a writer, his wife had to take down what he dictated. His wife explained that Malcolm dictated standing up, leaning on his knuckles on the top of his desk. Mr Lowry said that words would not come to him unless he was standing and leaning with the back of his hands on his desk. There were calluses on the backs of the knuckles and the first joints of the fingers. Dr McNeill told me that these were like anthropoid pads – something apes have from leaning on and dragging the backs of their hands on the ground. Other aspects of the physical exam were normal except for the legs: he had extensive varicose veins in both legs – likely sources of his leg pains from long periods of standing while dictating. Surgery was suggested and it was carried out at the old North Vancouver Hospital.

Mr Lowry finished his book, which was highly praised by critics but sold poorly. He brought a copy of his book to Dr McNeill but sheepishly admitted that he could not sign it because of his mental block. He asked Dr McNeill to give him a piece of paper in case the block would pass. When Dr McNeill told me this part of the story he pulled out a wrinkled prescription blank from one of his drawers. Apparently 2 months after he last saw Mr Lowry he received a letter – in it was the prescription blank and scrawled on it, “with affection, Malcolm Lowry.”

Lowry and his wife left Deep Cove and moved back to England in 1954 where he died in 1957, at age 48.–George Szasz, CM, MD